Garraud Olivier, Tissot Jean-Daniel
Faculty of Medicine, University of Lyon, Saint-Etienne, France.
Institut National de la Transfusion Sanguine, Paris, France.
Front Med (Lausanne). 2018 Apr 9;5:84. doi: 10.3389/fmed.2018.00084. eCollection 2018.
Blood transfusion is made possible because, in most countries and organizations, altruistic individuals voluntarily, anonymously, and generously donate (without compensation) either whole blood or separated components that are then processed and distributed by professionals, prior to being allocated to recipients in need. Being part of modern medicine, blood transfusion uses so-called standard blood components when relative to cellular fractions and fresh plasma. However, as will be discussed in this paper, strictly speaking, such so-called labile blood components are not completely standard. Furthermore, the prevalent system based on voluntary, non-remunerated blood donation is not yet universal and, despite claims by the World Health Organization that 100% of blood collection will be derived from altruistic donations by 2020 (postponed to 2025), many obstacles may hinder this ambition, especially when relative to the collection of the enormous amount of plasma destined for fractionation into plasma derivative or drugs. Finally, country organizations also vary due to the economy, sociology, politics, and epidemiology. This paper then, discusses the particulars (of which ethical considerations) of blood transfusion diversity and the consequences for donors, patients, and society.
输血之所以成为可能，是因为在大多数国家和组织中，无私的个人自愿、匿名且慷慨地（无偿）捐献全血或分离成分，然后由专业人员进行处理和分发，再分配给有需要的受血者。作为现代医学的一部分，输血在涉及细胞成分和新鲜血浆时使用所谓的标准血液成分。然而，正如本文将要讨论的，严格来说，这种所谓的不稳定血液成分并非完全标准。此外，基于自愿无偿献血的现行体系尚未普及，尽管世界卫生组织宣称到2020年（后推迟至2025年）所有血液采集都将来自无偿献血，但许多障碍可能会阻碍这一目标的实现，尤其是在采集大量用于分离成血浆衍生物或药物的血浆方面。最后，由于经济、社会学、政治和流行病学等因素，各国组织也存在差异。因此，本文将讨论输血多样性的具体情况（包括伦理考量）以及对献血者、患者和社会的影响。
